胃癌组织Mina53的表达及其临床病理意义

背景:Mina53是新近发现的一种由c-Myc诱导的核抗原,在结肠癌、食管癌等消化道肿瘤中高表达,可能参与了肿瘤的发生和发展。目前,Mina53在胃癌中的研究还相对较少。目的:探讨Mina53在胃癌发生、发展中的作用和临床病理意义。方法:收集胃癌手术标本68例,同期收集正常胃窦黏膜组织30例作为正常对照组。采用免疫组化技术检测Mina53、c-Myc、Ki-67的定位和表达情况,分析胃癌组织中Mina53与c-Myc、Ki-67表达,以及与胃癌主要临床病理特征的相关性。结果:Mina53、c-Myc和Ki-67在胃癌组织中的高表达率显著高于正常胃黏膜(63.2%对0%,P0.001;52.9%对0%,P0.001;55.9%对3.3%,P0.001)。胃癌组织中,Mina53与c-Myc、Ki-67的表达呈正相关(P0.001,P0.05)。Mina53高表达与患者的性别、年龄和肿瘤部位无关,而与病灶大小、分化程度、浸润深度、淋巴结转移、TNM分期相关(P0.01)。结论:Mina53在胃癌组织中表达增高,其表达与c-Myc和Ki-67呈正相关,并与胃癌的分化、浸润、转移等临床病理特征相关。Mina53可能参与了胃癌的发生和发展,并有望作为胃癌预后判断的标记物,为胃癌的基因治疗提供新的靶点。     

人结肠癌中凋亡抑制基因Survivin的表达

背景:细胞增殖和凋亡失衡将导致肿瘤的发生,并直接影响肿瘤的生物学行为。survivin是一种新的凋亡抑制基因,在大多数肿瘤中显著高表达。目的:探讨survivin基因在人结肠癌发生、发展中的作用,及其与p53基因的表达和结肠癌生物学行为的关系。方法:采用逆转录聚合酶链反应(RT鄄PCR)检测33例结肠癌组织及其相应癌旁组织和正常结肠黏膜中survivinmRNA和p53mRNA的表达,分析survivinmRNA的表达与p53mRNA的表达和结肠癌生物学行为的相关性。结果:69.7%的结肠癌组织中有survivinmRNA表达,表达率显著高于癌旁组织和正常结肠黏膜(42.4%和21.2%,P<0.01);survivin表达阴性癌组织的相应癌旁组织和正常结肠黏膜无一例有survivinmRNA表达。结肠癌组织中survivinmRNA的表达值显著高于癌旁组织和正常结肠黏膜(P<0.01)。33例结肠癌组织中仅2例p53mRNA表达缺失,癌旁组织和正常结肠黏膜中均有p53mRNA表达。结肠癌组织中p53mRNA的表达值与癌旁组织和正常结肠黏膜无显著差异;survivin表达阳性癌组织中p53mRNA的阳性表达率和表达值与survivin表达阴性组无显著差异。survivinmRNA和p53mRNA的表达与结肠癌的生物学行为无显著相关性。结论:survivin基因在人结肠癌组织中表达上调,提示其可能通过抑制结肠癌细胞凋亡,在结肠癌的发生、     

Cdk3在结肠癌变过程中的表达及其意义

目的:研究Cdk3在结肠息肉、结肠腺瘤、结肠癌组织中的表达,探讨Cdk3在结肠癌变过程中的演变规律及其意义.方法:用免疫组织化学和原位杂交的方法检测22例结肠癌组织、22例结肠腺瘤组织、24例结肠息肉组织中Cdk3蛋白和mRNA的表达.结果:Cdk3蛋白和mRNA在结肠息肉、结肠腺瘤、结肠癌组织中的表达呈核.质型,以质为主.图像分析结果显示,结肠癌组织中Cdk3蛋白表达平均光密度值(0.80±0.36)明显高于结肠腺瘤组织(0.48±0.22)和结肠息肉组织(0.25±0.13)(P<0.05),结肠腺瘤组织中Cdk3蛋白表达平均光密度值明显高于结肠息肉组织(P<0.05),结肠癌组织中的阳性细胞数(266.5±40.2)明显高于结肠腺瘤组织(132.0±37.4)和结肠息肉组织(129.3±26.7).结论:Cdk3在结肠癌变过程中表达逐步增强,在结肠癌组织中异常高表达,可能在结肠癌变过程中发挥重要作用.     

结肠癌组织中细胞周期蛋白E和增殖细胞核抗原表达的研究

目的研究细胞周期蛋白E(CyclinE)和增殖细胞核抗原(PCNA)在结肠癌组织中的表达及二者之间的关系。方法采用原位杂交法和免疫组化S-P法,对40例结肠癌、10例结肠腺瘤和10例结肠正常黏膜组织进行CyclinE mRNA和PCNA的检测。结果结肠癌组织中CyclinEmRNA的阳性表达率为62.5%,PCNA指数为(50.09±11.15),均显著高于结肠腺瘤和结肠正常组织(P<0.05);CyclinE mRNA表达阳性组的PCNA指数明显高于CyclinE mRNA阴性组(P<0.05);CyclinE mRNA与肿瘤的浸润深度、有无淋巴结转移密切相关(P<0.05),与肿瘤的分化程度、有无肝转移不相关(P>0.05);PCNA与肿瘤的浸润深度、分化程度及有无淋巴结转移密切相关(P<0.05),与有无肝转移无明显相关(P>0.05)。结论CyclinE可作为结肠癌的又一细胞增殖指标,其对结肠癌的发生、发展起重要作用。     

肿瘤增殖抗原Ki67和抑癌基因P16在肾上腺皮质肿瘤组织中的表达及意义

目的联合检测肿瘤增殖抗原Ki67和抑癌基因P16在肾上腺皮质肿瘤中的表达,探讨Ki67及P16与肾上腺皮质肿瘤的关系。方法应用免疫组化方法检测45例肾上腺皮质肿瘤(腺瘤39例、腺癌6例)及9例瘤旁正常组织标本中Ki67及P16的标记指数(LI)。结果Ki67在正常肾上腺组织不表达,在腺癌表达最高,腺瘤次之;P16在正常肾上腺组织表达最高,腺瘤次之,腺癌最低,Ki67和P16在肾上腺皮质恶性肿瘤表达的结果与良性肿瘤表达的结果相比较差异有统计学意义(均P<0.01),且存在负相关关系(r=-0.67,P<0.05)。Ki67的LI在肾上腺皮质腺瘤、腺癌的界定值为4%;P16的LI在肾上腺皮质腺瘤、腺癌的界定值为12%。结论Ki67及P16的表达与肾上腺肿瘤显著相关,Ki67的LI>4%和P16的LI<12%时,提示为腺癌。联合检测Ki67和P16在肾上腺皮质肿瘤的表达对鉴别良、恶性肾上腺皮质肿瘤具有重要的参考意义。     

结肠腺癌核仁素表达和Ki67标记的增殖指数的关系

目的检测结肠腺癌中核仁素(C23)表达和Ki67标记的增殖指数的关系,分析其临床意义。方法 65例结肠腺癌患者的临床资料及术后蜡块组织作为观察组,正常结肠黏膜组织25例作为对照组,采用免疫组化方法检测两组中C23和Ki67的表达。结果观察组中C23和Ki67的阳性率明显高于对照组(均P<0.001)。观察组中C23和Ki67表达与肿瘤最大径和浸润深度密切相关,C23表达与肿瘤分化程度密切相关。相关分析显示观察组中C23和Ki67呈正相关。结论结肠腺癌中C23和Ki67高表达可以促进肿瘤形成和进展,C23和Ki67有一定的协同作用。     

TKTL1在结肠腺瘤、结肠癌中的表达及其临床意义

背景:各种肿瘤组织均有TKTL1表达,其表达水平与肿瘤侵袭转移和预后密切相关。目的:探讨TKTL1在结肠腺瘤、结肠癌中的表达及其临床意义。方法:选取2015年3月—2018年5月至淄博市第一医院行结肠镜检查证实的30例正常结肠黏膜、84例结肠腺瘤以及手术证实的84例结肠癌组织,以免疫组化法检测TKTL1蛋白表达,并分析TKTL1表达与结肠腺瘤、结肠癌临床病理参数的关系。结果:结肠腺瘤、结肠癌的TKTL1表达率显著高于正常结肠黏膜(57. 1%、85. 7%对13. 3%,P 0. 01),且结肠癌TKTL1表达率明显高于结肠腺瘤(P 0. 01)。TKTL1表达与结肠腺瘤患者的性别、年龄、病理类型和病理特征无关(P 0. 05)。TKTL1表达与结肠癌患者的性别、年龄、组织分化程度无关(P 0. 05),而与TNM分期、远处转移、淋巴结转移、浸润深度相关(P 0. 05)。结论:TKTL1在结肠腺瘤、结肠癌中的表达显著高于正常结肠组织,且与结肠癌分期、转移有相关性,推测TKTL1表达与结肠癌的发生、发展密切相关。     

结肠腺癌患者癌组织中TPX2、PTEN和Ki67的关系及临床意义

目的检测结肠腺癌中TPX2、PTEN和Ki67的表达及临床价值。方法选择122例结肠腺癌术后留取的蜡块及患者的临床资料作为观察组,选择73例正常结肠黏膜组织作为对照组,采用免疫组织化学方法检测两组中TPX2、PTEN和Ki67的表达。结果观察组中TPX2和Ki67表达的阳性率明显高于对照组(P<0.05),观察组中PTEN表达的阳性率明显低于对照组(P<0.05),观察组中TPX2、PTEN和Ki67表达的阳性率与淋巴结转移、远处转移、浸润深度和临床分期密切相关(P<0.05)。相关分析显示观察组中TPX2和Ki67(r=0.45,P=0.043 2)的表达呈正相关,而PTEN和Ki67(r=-0.48,P=0.030 4)的表达呈负相关。结论结肠腺癌中TPX2和Ki67高表达、PTEN低表达时对病变的发生和进展均具有重要促进作用。TPX2和PTEN对增殖作用的影响可能是影响肿瘤进展的重要机制。     

Mina53和H-钙黏蛋白在结肠癌组织中的表达水平及其临床意义

目的分析结肠癌组织中Mina53、H-钙黏蛋白的表达水平及临床意义。方法选取2015年7月至2017年12月在张家港市中医医院内镜中心行活组织检查的30例结肠癌患者作为研究对象,收集患者的结肠癌组织和癌旁组织,采用RT-PCR法和免疫组织化学法检测Mina53、H-钙黏蛋白的表达水平,并分析其与患者临床病理特征的关系。结果与癌旁组织相比,结肠癌组织中Mina53的信使RNA(mRNA)表达水平升高,H-钙黏蛋白的mRNA表达水平降低,且差异均具有统计学意义(P均0.05);在结肠癌组织和癌旁组织中,Mina53的阳性率分别为63.3%和6.7%,H-钙黏蛋白的阳性率分别为56.7%和93.3%;Mina53蛋白阳性率在肿瘤直径≥5cm、存在脉管侵犯、低分化癌、Ⅲ+Ⅳ期和存在淋巴结转移的患者中显著升高,差异有统计学意义(P0.05);H-钙黏蛋白阳性率在肿瘤直径5cm、不存在脉管侵犯、中高分化癌、Ⅰ+Ⅱ期和不存在淋巴结转移的患者中显著升高,差异均有统计学意义(P均0.05)。结论结肠癌组织中Mina53的表达水平升高,H-钙黏蛋白的表达水平降低,且它们的表达水平与肿瘤直径、脉管侵犯、分化程度、TNM分期及淋巴结转移等临床病理特征有关。     

喉鳞癌组织中脆性组氨酸三联体基因和增殖蛋白的关系

目的检测喉鳞癌中脆性组氨酸三联体基因(FHIT)、增殖细胞核抗原(PCNA)和Ki67增殖蛋白(Ki67)的表达特征,探讨FHIT对增殖的作用。方法 67例喉鳞癌患者的临床资料和术后蜡块组织作为观察组,喉黏膜不典型增生的术后组织53例作为对照组,收集上述距肿物边缘2 cm非肿瘤性喉黏膜组织53例作为正常对照组。应用免疫组化二步法检测三组FHIT、PCNA和Ki67的表达。结果三组FHIT、PCNA和Ki67的阳性率差别显著(P0.000 1)。观察组中FHIT、PCNA和Ki67的阳性率均与肿瘤最大径、分化程度、是否伴有脉管内瘤栓相关。PCNA和Ki67的表达与淋巴结转移相关。线性相关分析显示观察组中FHIT和PCNA、FHIT和Ki67的表达均具有负相关性。结论喉鳞癌术后组织中FHIT低表达,PCNA和Ki67高表达对促进肿瘤形成和进展有一定作用,FHIT在调节肿瘤性进展过程中可能与对肿瘤细胞增殖的调节有关。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。